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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does this MRI report indicate?

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Dr. Bruno Mascarenhas

Neurologist, Surgical

Practicing since :2000

Answered : 803 Questions

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Posted on Mon, 29 May 2017 in Brain and Spine
Question: My lumbar MRI shows the following:
19mm low signal intensity structure withing central call at l4-l5, extending disc fragment posterior to superior margin of l5 with sequestered disc fragment secondary to l4-l5, marked compression of the call sacred with severe central canal stenosis at l5, impingement on right l5 nerve root and posterior displacement of nerve root, 2 mm disc herniation at l5-s1, tear of post annul us with 2mm midline herniation L3-l4, sequestered disc fragment at l4-l5, disc desiccation at L3-l4 and l4-l5. What does this all mean and what is my prognosis? Thank you.
doctor
Answered by Dr. Bruno Mascarenhas 1 hour later
Brief Answer:
Please mention your complaints

Detailed Answer:
dear madam

you have shared the MRI report and treatment particulars

please mention the complaints

do you have pain
do you have numbness
do you have weakness
do you have difficulty in passing urine
do you have difficulty in passing motion

the further course of treatment depends on the presence or absence of above complaints
Above answer was peer-reviewed by : Dr. Remy Koshy
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Follow up: Dr. Bruno Mascarenhas 2 hours later
complaints: pain and touch sensitivity to lumbar region of back, radiating nerve pain down right leg to foot, numbness in right outer thigh, tingling and warmth in right calf, radiating pain down left leg to knee, right leg will loose all strength and collapse, muscle spasms of right buttocks and thigh which prevent toes from touching ground out of pain, extreme pain shots down right leg to point of collapse, 3 episodes of bladder control loss (may be due to muscle relaxers), right leg will feel cold after severe nerve pain (usually brought on by walking short distance where thigh will go completely numb and calf will be extreme pain then after relaxing for about 20 min whole leg will feel like it just got out of ice bath). those are my basic complaints.
doctor
Answered by Dr. Bruno Mascarenhas 20 hours later
Brief Answer:
mandatory to do surgery at the earliest.

Detailed Answer:
Hi again,

Welcome back, I am Dr.J XXXXXXX Anto Bruno Mascarenhas. I have gone through your query with diligence and would like you to know that I am here to help you.

Symptoms :
1. Pain and touch sensitivity to lumbar region of back,
2. Radiating nerve pain down right leg to foot,
3. Numbness in right outer thigh,
4. Tingling and warmth in right calf,
5. Radiating pain down left leg to knee,
6. Right leg will loose all strength and collapse,
7. Muscle spasms of right buttocks and thigh which prevent toes from touching ground out of pain,
8. Extreme pain shots down right leg to point of collapse,
9. 3 episodes of bladder control loss (may be due to muscle relaxers),
10. right leg will feel cold after severe nerve pain (usually brought on by walking short distance where thigh will go completely numb and calf will be extreme pain then after relaxing for about 20 min whole leg will feel like it just got out of ice bath.

Motor System, Sensory System, Reflexes and Autonomic System are all involved

Hence,
Surgery is Needed
Laminectomy at three levels and Excision of Disc at two levels is needed

Please consult a Neurosurgeon in your Place for Further management and proceed accordingly.

Since Bladder is involved (3 episodes of bladder control loss), it is mandatory to do the surgery at the earliest.

Hope you found the answer helpful.

If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions.

Best Wishes for Speedy Recovery
Let me know if I can assist you further.
Take care.

-oOo-

PS 1: After all your doubts have been cleared, kindly (a) close this question (b) rate my replies and (c) provide your valuable feedback.

PS 2: In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at http://bit.ly/askdrbruno


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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